State suspends doctor's right to prescribe most pain killers

Meredith Cohn, The Baltimore Sun

State health officials took the unusual step Thursday of suspending the authority of a Salisbury pain doctor to write prescriptions for opiates, narcotics and all other controlled dangerous substances commonly used to treat pain.

The officials said Dr. Brent R. Fox wasn't conducting thorough exams of patients and was prescribing drugs in amounts outside of the standards. They will consider a permanent revocation next week and have referred the case to the state Board of Physicians for investigation of his right to practice medicine.

"We have the authority to act," said Frances B. Phillips, deputy secretary of public health services for the Maryland Department of Health and Mental Hygiene. "We thought it was important to act fast because we believed he was a danger to the public."

The state routinely inspects doctors and pharmacists who regularly dispense controlled dangerous substances. However, Phillips acknowledges it was unusual for the state to exert its authority to suspend someone. But she said state officials could take similar steps in the future.

Fox's case was referred to the state by a managed-care organization with which Fox was affiliated. Fox, who operates Peninsula Pain Management in Salisbury, could not be reached for comment.

Normally, a referral would go to the Board of Physicians, which oversees all doctors' licenses in the state. It has come under fire recently for its backlog of investigations.

The board doesn't generally confirm the existence of its investigations. Its deputy director, John Papavasiliou, did say, "We do share information [with the Department of Health and Mental Hygiene] when it's appropriate."

He also said that suspensions by the board related to prescription drugs are not uncommon, though he couldn't immediately offer statistics.

According to the board's website, Fox, 56, has been licensed in the state since 1987. State records show he registered his business with the state in 2008 as a Fox Laser & Skin Health Specialists for cosmetic treatments. He changed the name to Peninsula Pain Management in January 2010.

He continues to have privileges at Peninsula Regional Medical Center in Salisbury, where he once provided anesthesia for patients. A spokesman said he no longer provides that service there.

State health officials in general have been seeking to crack down on prescription drug abuse but preserve the ability of those who need the medications to acquire them.

The General Assembly passed a law during the 2011 session to create a new monitoring system common in other states. It requires pharmacies to log each filled prescription in a database so prescribers in doctors' offices, emergency rooms and urgent care facilities can check before writing prescriptions for the same medications.

Phillips said the system would be up and running soon.

The effort was made because the number of people abusing painkillers and other prescription drugs in the state has been rising sharply in recent years.

National drug officials say prescription painkillers, stimulants and depressants are now the most widely abused drugs behind marijuana, with more than 6,000 Americans a day abusing them for the first time. In Maryland, the number of people seeking treatment for addiction to a prescription drug rose to more than 7,000 in 2010 from 3,400 in 2007.

The wide availability and the highly addictive nature of some of the drugs are likely reasons for the rise, officials said.